骨科手术患者医院感染病原菌分布与危险因素分析  

Analysis of pathogenic bacterial distribution and risk factors of hospital infections in orthopedics patients

作　　者：于德军[1] 刘丽晶[2] 刘波[3] 

机构地区：[1]齐齐哈尔医学院附属第三医院骨外二科,黑龙江齐齐哈尔161000 [2]齐齐哈尔医学院附属第三医院妇产科,黑龙江齐齐哈尔161000 [3]齐齐哈尔医学院附属第三医院呼吸科,黑龙江齐齐哈尔161000

出　　处：《中华医院感染学杂志》2014年第16期3945-3947,共3页Chinese Journal of Nosocomiology

基　　金：黑龙江省卫生厅研究基金资助项目(2011-276)

摘　　要：目的分析医院骨科手术后住院患者医院感染的状况,医院感染的病原菌及其耐药性,并对感染发生的危险因素进行分析,以降低感染率。方法选取2011年1月-2012年12月在骨科进行手术治疗的987例患者,将其进行分组,其中感染组105例、未感染组882例,对感染患者的病原菌进行耐药性分析,数据采用SPSS 18.0进行处理。结果 987例骨科手术后住院患者发生医院感染105例,感染率10.60%,对感染患者送检标本进行分离培养,分离出病原菌112株,革兰阳性菌47株占41.96%,革兰阴性菌65株占58.04%;主要革兰阳性菌对乙酰唑胺和替考拉宁的耐药率较低,革兰阴性菌对美罗培南和阿米卡星的耐药率较低,均<5.00%;患者年龄大、住院时间长、合并有其他疾病、应用呼吸机和导尿管以及未进行预防性应用抗菌药物等,是医院骨科手术住院患者医院感染的危险因素。结论骨科手术患者医院感染的发生率高,临床应根据骨科手术患者医院感染发生的危险因素,分离培养病原菌并进行药敏试验,选用耐药率低的抗菌药物进行及时的治疗,控制感染的发生。OBJECTIVE To analyze the status of hospital infection of inpatients after orthopedic surgeries as well as the pathogenic bacteria and their drug resistance of infection for orthopedics patients,and analyze the risk factors so as to reduce infection rate.METHODS Totally 987 patients undergoing orthopedic surgeries during Jan.2011 to Dec.2012 were chosen and divided into the infection group（n=105）and the non-infection group（n=882）,and pathogenic bacteria were isolated and cultured,the drug sensitivity tests were conducted.Data were analyzed by SPSS 18.0.RESULTS The infection rate was 10.6% as there were 105 cases of hospital infection in 987 surgical patients,112 strains of pathogenic bacteria were isolated,including 47 strains of gram-positire bacteria,accounting for 41.96%,and 65 strains of gram-negative bacteria accounting for 58.04%.gram-positire bacteria had a low resistance to acetazolamide and teicoplanin,gram-negative bacteria had a low resistance to meropenem and amikacin,all resistance5.00%.The risk factors of infection included age,duration of hospitalization,complication with other diseases,the application of respirator and catheter and no medication of prophylactic antibiotics.CONCLUSION The incidence of hospital infection in inpatients after orthopedic surgeries is high.And pathogenic bacteria should be isolated based on the risk factors,and drug sensitivity test performed,the low resistance antibacterial chosen to treat infection once infection occurred.

关 键 词：骨科 感染 病原菌 危险因素 

分 类 号：R378[医药卫生—病原生物学]